Clinical Psychology

determined; there are no accidents. The slip of the
tongue and the forgotten appointment are not sim-
ple mistakes. Rather, they represent the conscious
expression of an unconscious wish. These little mis-
takes of everyday life are like dreams in the sense
that sexual and aggressive urges receive partial grat-
ification even though they interfere with our lives
in minor ways. When the patient makes such mis-
takes in therapy or recounts during therapy mistakes
made outside the therapy room, the therapist
receives additional data by which to assess the
patient’s problems. In some instances, the meaning
of the mistake is not readily apparent, and the
patient may be asked to free-associate to the mis-
take. These associations, coupled with the thera-
pist’s interpretation, can help provide the patient
with added insight.

Resistance

During the course of psychotherapy, the patient
will attempt to ward off efforts to dissolve neurotic
methods of resolving problems. This characteristic
defense, mentioned earlier, is called resistance.
Patients are typically loath to give up behaviors
that have been working, even though these beha-
viors may cause great distress—the distress, in fact,

that led the patients to seek help in the first place. In

addition, patients find painful subjects difficult to

contemplate or discuss. For example, a male patient

who has always feared his father or has felt that he

did not measure up to his father’s standards may not

wish to discuss or even recall matters related to his

father. Although a certain amount of resistance is

expected from most patients, when the resistance

becomes sufficient to retard the progress of therapy,

it must be recognized and dealt with by the

therapist.

As previously mentioned, the termresistanceis

used to describe any client action or behavior that

prevents insight or prevents bringing unconscious

material into consciousness. Resistance takes many

forms. Patients may begin to talk less, to pause

longer, or to report that their minds are blank.

Lengthy silences are also frequent. Sometimes a

patient may repeatedly talk around a point or end-

lessly repeat the same material. Therapy may become

an arena for discussing such problems as unemploy-

ment or taxes—weighty issues, but hardly the ones

that brought the patient to therapy. Some patients

may intellectualize about the relative merits of primal

screaming versus nude marathons or even the effect

of Freud’s boyhood on the subsequent develop-

ment of psychoanalysis. If the patient knows that

BOX12-2 Focus on Professional Issues: Freud’s Self-Analysis

To support his notion that people are motivated

by sexual wishes that go all the way back to their

childhood, Freud drew upon the results of his own

self-analysis.

Freud’s father died in 1896. This disturbed Freud a

great deal, even though his father was old and ill. In

fact, Freud became extremely anxious and depressed,

so much so that his work was severely hampered. He

became so disturbed at his own reactions that he

decided to embark upon a detailed self-analysis,

drawing on his dreams, associations, and behavior.

One childhood dream in particular seemed

important. This was a dream Freud remembered hav-

ing when he was 7 or 8 years old. Thirty years later, he

interpreted it. In his dream, he saw his“beloved

mother, with a peculiarly calm, sleeping countenance,

carried into the room and laid on the bed by two (or

three) persons with birds’beaks”(Freud, 1938, p. 522).

His free associations led him to the idea of death and

to an expression on his grandfather’s face shortly

before his death. This was a composite dream, then,

combining elements of both his mother and grandfa-

ther. From here, his associations took him to the idea

of a dying father. Freud then realized to his dismay

that unconsciously he had harbored as a child hostile

wishes toward his father. Additional associations (e.g.,

the German slang word for sexual intercourse was

derived from the German word for bird) led him inev-

itably to the conclusion that his childhood sexual urges

were directed toward his mother. So it was that the

unconscious Oedipal strivings he had interpreted so

often in his patients were equally true for him.

352 CHAPTER 12